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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374845327
Report Date: 04/24/2025
Date Signed: 04/24/2025 03:50:15 PM

Document Has Been Signed on 04/24/2025 03:50 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:PEPPERTREE MONTESSORIFACILITY NUMBER:
374845327
ADMINISTRATOR/
DIRECTOR:		GILLINS, CHERYLFACILITY TYPE:
830
ADDRESS:427 COLLEGE BLVD, STE ITELEPHONE:
(760) 940-1931
CITY:OCEANSIDESTATE: CAZIP CODE:
92057
CAPACITY: 40TOTAL ENROLLED CHILDREN: 40CENSUS: 18DATE:
04/24/2025
TYPE OF VISIT:Annual/RequiredUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Cheryl Gillins, DirectorTIME VISIT/
INSPECTION COMPLETED:
01:30 PM
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Licensing Program Analyst (LPA) Tricia Danielson conducted an unannounced annual inspection on April 24, 2025, at 10:00 AM. LPA met with Teacher Susana Garcia Hernandez, who provided a tour of the center. This is a combination childcare center, and the following licensed programs were also inspected on this date: #374845328- Peppertree Montessori Day Care Center. A tour of both the indoor and outdoor areas of the facility was conducted, and the following observations were noted. Director Cheryl Gillins arrived during LPA's visit.

The required postings, including the facility license, Emergency Disaster Plan (LIC610), Earthquake Preparedness Checklist (LIC9148), Parent’s Rights Poster (PUB393), Personal Rights (LIC613A), Child Car Seat Law, and menus, were observed to be up to date and appropriately displayed. The facility is operating within the capacity limits as stated on its license.

During the inspection, staff-to-child ratios were observed. In room Infant A, the ratio was two (2) teachers and two (2) aids with nine (9) infants. In room Toddler A, the ratio was two (2) teachers with nine (9) toddlers ages eighteen (18) to twenty-four (24) months. Classrooms contained age and size-appropriate furniture and equipment, and were free of hazards. Garcia Hernandez confirmed that no weapons are present on the premises, and there are no accessible bodies of water. Garcia Hernandez also confirmed and is aware that any wading pools or similar items must be emptied immediately after use and stored upright. Drinking water is available both indoors and outdoors via filtered water in personal drinking vessels. LPA verified that lead testing was completed on 9/1/2022 per PIN 21-21.1-CCP directives, and the facility was referred to the Department’s website for additional lead toxicity prevention and water testing information.

In room Infant A, LPA observed four (4) spray bottles accessible to children hanging off the changing table. (CONTINUED ON LIC809-C)

NAME OF LICENSING PROGRAM MANAGER: Deborah Mullen
NAME OF LICENSING PROGRAM ANALYST: Tricia Danielson
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 04/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/24/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: PEPPERTREE MONTESSORI
FACILITY NUMBER: 374845327
VISIT DATE: 04/24/2025
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(CONTINUED FROM LIC809) One spray bottle was labeled as a soap and water mixture, one contained a floor disinfectant, one contained a general disinfectant, and one was labeled as Windex. Garcia Hernandez immediately secured the spray bottles during LPA's visit. The floors were observed to be clean, safe, and well maintained. Highchairs and tables have broad based legs, and trays that lock into place for additional safety. Changing tables are within arm’s reach of a sink, have a minimum one-inch-thick padding, and feature raised sides of at least three inches covered in washable vinyl or plastic.
The bathrooms were found to be clean and safe. In room Toddler A, there were two (2) toilets and three (3) sinks available and in working condition.
Outdoor play areas are equipped with age and size-appropriate equipment in good condition. The food preparation area is clean, free of litter and pests, and properly maintained. LPA observed ant poison and cleaning solutions in the under sink cabinet which was not secured with any type of locking mechanism. LPA also observed a large knife located in a kitchen drawer which was also not secured with any type of locking mechanism. The kitchen door did not latch properly and was not locked as well. Filtered water is used for food preparation. Food is stored correctly to prevent contamination. Waste containers have tight-fitting covers and are in good repair.
The sign-in/sign-out records were reviewed and found to be compliant with regulations. Disaster drills are conducted at least every six months, with the most recent drill occurring on April 14, 2025. A review of children’s and staff records confirmed that all required documents are complete. Staff qualifications meet licensing requirements, and at least one staff member has a valid Pediatric CPR/First Aid certification and was present, with certification expiration dates documented. The director has completed Health and Safety Training. Background clearances for all required staff members have been verified, ensuring compliance with criminal record and child abuse index clearance requirements.
The director was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption before working in the facility. Non-compliance with this regulation may result in a civil penalty of $100 per day for up to five days, or up to 30 days for repeat violations.
LPA discussed safe sleep regulations and provided the director with resources available at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep. Additionally, LPA recommended checking the Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ to ensure infant devices are not subject to recalls and encouraged registration of all infant devices with the CPSC for recall notifications.

(CONTINUED ON LIC809-C)

NAME OF LICENSING PROGRAM MANAGER: Deborah Mullen
NAME OF LICENSING PROGRAM ANALYST: Tricia Danielson
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2025
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: PEPPERTREE MONTESSORI
FACILITY NUMBER: 374845327
VISIT DATE: 04/24/2025
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(CONTINUED FROM LIC809-C) LPA reviewed medication storage, equipment and supply storage, and record-keeping procedures. Information regarding IMS policies, as outlined in PIN 22-02-CCP, was provided. Resources regarding ADA compliance were also shared, including the US Department of Justice ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY), and the publication "Commonly Asked Questions about Child Care Centers and the ADA" available at https://www.ada.gov/resources/child-care-centers/.

The director was informed about the MyChildCarePlan.org website, a consumer education resource that connects families to childcare providers and Resource and Referral Agencies (R&Rs) across California. Licensing forms and regulations for Child Care Centers are available on the Department’s website at www.ccld.ca.gov, where providers can also subscribe to receive important updates by email.

LPA reviewed reporting requirements with Director Gillins, emphasizing that any unusual incidents or injuries must be reported to the Department within 24 hours via telephone and within seven days in writing. The Duty Officer can be reached Monday through Friday from 8:00 AM to 5:00 PM at (951) 782-4200, or reports may be emailed to UnusualIncidentReportsDO10@dss.ca.gov.

To enhance the quality of inspections, a survey may be sent to the email address on file. LPA encouraged participation and provided the email inspectionprocess@dss.ca.gov for any questions regarding the inspection process. Additional information about the inspection methods and tools is available at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

On April 23, 2025, a search of the California Attorney General - Megan’s Law website was conducted, and no registered sex offenders were found at the facility address. Some offenders may not be subject to public disclosure under state law; however, the Department performs monthly cross-references of all CCLD facility addresses with the Megan’s Law database provided by the California Department of Justice.

Director Gillins was requested to update and submit the following documents within 30 days, if applicable:

· LIC 500 Personnel Report,


· LIC 610 Emergency & Disaster Plan,
· Parent Handbook/Program Curriculum/Admission Policies and Procedures/Fee Schedule (if updates have

(CONTINUED ON LIC809-C)

NAME OF LICENSING PROGRAM MANAGER: Deborah Mullen
NAME OF LICENSING PROGRAM ANALYST: Tricia Danielson
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2025
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: PEPPERTREE MONTESSORI
FACILITY NUMBER: 374845327
VISIT DATE: 04/24/2025
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(CONTINUED FROM LIC809-C)
been made or if the file copy is older than two years),
· LIC 309 Administrative Organization (if updated within the past two years), and
· LIC 308 Designation of Administrative Responsibility (if updated within the past two years).

See LIC809-D for cited deficiencies. A Notice of Site Visit was provided and must remain posted for 30 days.

An exit interview was conducted with Director Gillins, and a copy of this report was reviewed. Appeal rights were also discussed and provided during the exit interview as well.

NAME OF LICENSING PROGRAM MANAGER: Deborah Mullen
NAME OF LICENSING PROGRAM ANALYST: Tricia Danielson
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2025
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 04/24/2025 03:50 PM - It Cannot Be Edited


Created By: Tricia Danielson On 04/24/2025 at 01:33 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: PEPPERTREE MONTESSORI
FACILITY NUMBER: 374845327

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/24/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101238(g)
Buildings and Grounds
(g) Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children shall be stored where inaccessible to children.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA's observation, the licensee did not ensure spray bottles with disinfectants and cleaning solutions were inaccessible to children in care in Infant room A which posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/01/2025
Plan of Correction
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Deficiency corrected at the time of LPA's visit.
Type B
Section Cited
CCR
101238(g)(1)
Buildings and Grounds
(g) Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children shall be stored where inaccessible to children. (1) Storage areas for poisons shall be locked.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA's observation, the licensee did not ensure ant poison was inaccessible to children in care in the kitchen/food prep area which posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/24/2025
Plan of Correction
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Deficiency corrected at the time of LPA's visit
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Deborah Mullen
NAME OF LICENSING PROGRAM MANAGER:
Tricia Danielson
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 04/24/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/24/2025


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